The Research Of Schizophrenia Burden Of A City In AnHui Province

Objectives From aspects of disease-economic burden and epidemiological burden, to investigate disease burden of schizophrenia in Xuan City of An Hui Province, to evaluate the severity of the disease burden of schizophrenia, and to provide reliable basis for relevant government departments to make decisions.Methods Patients with schizophrenia visiting three tertiary referral hospitals of Xuancheng City, were selected from January 1, 2010 to December 31, 2014. A total of316 patients with schizophrenia were included in the study. The basic information and direct medical costs of patients were collected by reading medical records and the HIS system. The indirect medical costs were collected through face-to-face questionnaire and telephone interview. The direct and indirect economic burdens caused by patients with schizophrenia of Xuancheng were calculated using the basic information and per capita GDP of the city’s population acquired through the statistics bureau of Xuancheng city.Meanwhile, the disability adjusted life years were used to evaluate epidemiological burden of schizophrenia. The multiple linear regression was performed to explore the factors associated with total economic burden of schizophrenia.Results 1 The indirect medical costs and direct medical costs of each year were higher than the previous year of 316 cases of patients with schizophrenia in Xuancheng City from 2010 to 2014, except 2013. The direct economic burden of patients with schizophrenia was 4 006 620 yuan in 2010, 4 119 457 yuan in 2011, 4 330 197 yuan in2012, 4 301 720 yuan in 2013, and 4 595 212 yuan in 2014(the highest), respectively,with a total of 21 353 206 yuan in 5 years. 2 Both indirect medical costs and direct medical costs of patients with schizophrenia showed an increasing trend year by year of Xuancheng City from 2010 to 2014, except 2013. Among them, treatment fees, other fees,daily room fees, examination and nursing fees were in the top five with percentage of47.24%, 15.81%, 10.67%, 9.71% and 7.54%, respectively. The annual direct economic burdens of patients with schizophrenia in different groups stratified by gender and registered permanent residence were higher than that of the previous year except 2013,showing a increasing trend year by year. The per capita costs of male and female patients in five years were rising year by year, with higher costs among men than women. The percapita costs of town and rural patients were also rising year by year, with higher costs among patients from urban than those from rural town. 3 DALYs of schizophrenia patients in Xuancheng City from 2010 to 2014 were 2.33, 2.45, 2.60, 2.55, and 2.71 years per thousand people, respectively. Disability caused by years of life lost was greater than death caused by years of life lost. Disability caused by years of life lost accounted for97.50%, 97.38%, 97.53%, 97.69%, and 97.43% of total disability adjusted life years in five years, respectively. Both the premature death and disability caused by years of life lost of males were higher than females every year. 4 The indirect economic burdens of Xuancheng City from 2010 to 2014 were 61 608 086 yuan, 79 393 873 yuan, 94 911417 yuan, 107 747 825 yuan, and 123 818 505 yuan, respectively, with a rising trend during the 5 years. The annual indirect economic burden of men was higher than that of women. 5 The total economic burdens of Xuancheng City in 2010 to 2014 were rising year by year, and were 65 614 706 yuan, 83 513 330 yuan, 99 241 614 yuan, 112 049 545 yuan, and 128 413 717 yuan, respectively, with a total of 488 832 911 yuan. The ratio of the direct and indirect economic burden was about 1:21, and the indirect economic burden was a major component of the total economic burden. 6 Results of Multiple linear regression analysis showed that gender, residence, the average hospitalization frequency and average hospitalization days may be the main influencing factors of total economic burdens of schizophrenia, with the coefficient of determination R2=0.532.Conclusion The economic burden caused by patients with schizophrenia was heavy to their family and society of Xuancheng City in Anhui Province, which was given priority to indirect economic burden. The economic burden of patients with schizophrenia was higher among males and patients from urban compared to females and those from rural town. Disability caused by the loss of healthy life years of patients was greater than death caused by the loss of healthy life years.